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SPSSI Policy News RSS Feed - September 16, 2009

Event Recap

Campaign for Mental Health Reform Hosts Briefing on How Health Care Legislation Addresses Mental Health Issues

The Campaign for Mental Health Reform hosted a panel discussion on Wednesday, September 16th that covered a range of policy issues from the public option of the health care bill, to children’s mental health coverage, to the need for more advocacy efforts on behalf of mental health reform.

The briefing was also part of an effort to convince representatives to put pressure on Secretaries Solis, Sebelius and Geithner to finalize the regulations on the “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.”  Regulations must be issued by October 3rd in order to ensure equal treatment for mental health and to prevent tactics that health plans and business groups might use to undermine the law.

Speakers:

William Emmet, Director for the Campaign for Mental Health Reform
Debbie Curtis, Chief of Staff for Representative Pete Stark (CA-13)
Laurel Stine, Director of Federal Relations, Bazelon Center for Mental Health Law
Kirsten Beronio, VP for Public Policy and Advocacy, Mental Health America
Elizabeth Prewitt, Director of Government Relations, National Association of State Mental Health Program Directors
Alexa Eggleston, Director of Public Policy, National Council for Community Behavioral Healthcare

Highlights:

Debbie Curtis spoke on behalf of Representative Stark who has played a critical role in the mental health reform effort.  She spoke about the importance of advocacy in mental health issues.  Curtis said that there are representatives who would like to see progress in mental health reform, but first need assurance that in doing so, they represent a prevalent interest among health groups and their constituents.

Kirsten Beronio spoke about the importance of preventative mental health care, particularly expanding treatment for children.  “For half of the people with mental illness, their conditions begin at age 14 but they won’t get treatment until age 24”, she said.  Having untreated mental health conditions increases the risk for chronic physical illness as well.  Beronio emphasizes the fact that the best preventative measures are to start treatment for these conditions when they begin at an early age.  The House mental health framework includes requirements for private companies to provide these preventative services. 

Alexa Eggleston gave a criminal justice perspective to the mental health discussion.  She spoke about the relationship between drug and alcohol abuse prevention and crime prevention.  One in every four people incarcerated are alcohol dependent, and three out of every four were under the influence of drugs or alcohol when they committed their offense. Given the trend of alcohol and drug addiction in adults, it is of utmost importance that those released from prison are given adequate support and rehabilitation.

Regulations to implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008

The Act, passed on October 3rd, 2008, requires that health insurance plans have equal subsidies, co-payments and out-of-pocket expenses for mental health disorders and “medical disorders.”  The Act also requires equal coverage and treatment limits. With or without regulations, the Act comes into effect, for most plans, on January 1st.  Without specific regulations, there are several ways in which health insurance companies and business groups can avoid providing equal treatment for mental health disorders.

Representative Patrick Kennedy wrote a letter to the secretaries of the departments of labor, treasury and health and human services highlighting some of the important issues in the Act that might be hindered or delayed without specific regulation.

Excerpt from the letter:

“Congress carefully considered mental health parity legislation for over twelve years prior to its enactment, and we are hopeful that the promulgated regulations will clearly reflect Congressional intent, especially on several important issues:

• Scope of services:  It is the intent of this legislation that patients have access to the full scope of services, medically-appropriate for their condition. Regulations should clarify that patients have access to the full scope of services for mental health and substance use disorders which are medically appropriate

• Medical management:  It is the intent of this legislation that plans retain the right to medically manage mental health and substance use disorder benefits, so long as the medical management criteria, including application of scientific research criteria, is no more restrictive than for medical/surgical benefits;

• “Separate but equal” is not parity:  Separate deductible caps for medical/surgical benefits and mental provides present a significant barrier to treatment, is discriminatory and should be prohibited;

• Treatment limitations:  The refusal of plans to reimburse medically appropriate mental health/substance use disorder treatments is a violation of the “treatment limitations” definition as stated in the Wellstone Domenici Act and should be prohibited; and,

• Timely implementation:  Timely implementation of the regulations is critical to avoid continued health discrimination of those with mental health and substance use disorders.”

Abigail Woodruff, SPSSI Policy Intern, attended this briefing.  For more information contact awoodruff@spssi.org.

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